Within one year of stroke, a quarter of patients develop PTSD

Within a year of stroke, a quarter of patients develop PTSD
Within a year of stroke, a quarter of patients develop PTSD

HealthDay News – Almost one in four survivors of a stroke or transient ischemic attack (TIA) develop significant posttraumatic stress disorder (PTSD) within a year of the incident, according to a study published in PLOS ONE.

Donald Edmondson, PhD, from the Columbia University Medical Center in New York City, and colleagues conducted a literature review of several medical databases in January of this year.  They found that 23% of the relevant patients developed PTSD in the year following a stroke or TIA, prompting them to encourage health care providers to “find novel ways to try to prevent PTSD and to treat it in different types of settings.”

One suggested method was “training neurologists and rehab physicians and general practitioners to learn some of the behavioral approaches and pharmacological approaches to treatment.”

PTSD, the anxiety disorder caused by exposure to a traumatic event, is often linked primarily to external factors “such as combat or sexual assault.”  However, recent studies have shown PTSD developing on account of medical conditions in patients, prominently those who have survived heart attacks.  Noting “the similarity in the pathophysiology between strokes and heart attacks,” Edmondson and colleagues set out to determine if a similar trend could be found for survivors of strokes and TIAs.

The literature review yielded more than 1200 articles on the subject of strokes and TIAs, of which nine met the researchers' criteria.  Information was gathered on the 1,138 participants in the nine articles.  All patients were from either the US or Europe and the mean age was 64.5 years.

It was found that 23% of patients developed PTSD within a year of having a stroke or TIA, although that figure dropped to 11% for the development of PTSD after more than a year.  The type of assessment was a determining factor as well: 28% of those assessing themselves reported PTSD, while only 6% of those clinically assessed were found to have the disorder.

Overall, 13% of the patients developed PTSD at some point.

Applying these figures to the average annual number of stroke and TIA survivors, the study suggested that approximately 297,850 patients suffering from a stroke or TIA will develop PTSD.

While allowing that more studies needed to be done, the researchers also proposed the possibility that, since PTSD often causes secondary behavior such as medication nonadherence, it might be a “significant, novel risk factor for recurrent stroke.”

Therefore, clinicians “should consider screening for PTSD in stroke survivors,” they concluded.

The study noted several potential limitations such as the relatively small sample size and the use of PTSD screening questionnaires not validated for stroke survivors.


References

  1. Donaldson E et al. PLOS ONE. 2013; doi:10.1371/journal.pone.0066435.s0012.
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